The GOP scored a pre-dawn triumph in the Ways and Means Committee after nearly 18 hours of debate along party lines, as the panel approved legislation to reshape the way millions of Americans pay for medical care, including abolishing the tax penalty Obama's statute imposes on people who don't purchase insurance.

Elsewhere at the Capitol, lawmakers on the Energy and Commerce Committee struggled past the 24-hour mark, with pressed suits and coiffed hair giving way to rumples and wrinkles. The lawmakers guzzled coffee and took breaks in their private cloakrooms but couldn't stray far out of fear they could miss a vote.

Republican Richard Hudson of North Carolina said, "I cheated. I snuck down to the gym at five and took a shower and put on a clean shirt."

Earlier, Republicans claimed progress as the Ways and Means Committee voted its approval. Said panel chairman Kevin Brady of Texas: "We voted repeatedly to end Obamacare's crushing taxes and mandates and ensure patients have more power over their own health care."

But the panel's top Democrat, Richard Neal of Massachusetts, protested that the GOP bill "would drastically increase costs and lower coverage and quality care."

The intense effort underscored GOP leaders' desire to keep the momentum on their drive to undo Obama's health law after seven years of promises to voters. President Donald Trump is telling lawmakers he's all-in on the endeavor, and he assigned Vice President Mike Pence to travel to Louisville, Kentucky, on Saturday, home state of one of the most prominent GOP critics, Sen. Rand Paul.

The White House and Republican leaders confront a GOP and outside groups badly divided over the party's high-stakes overhaul campaign, including conservatives like Paul who say the party should simply pursue a straight-forward repeal bill.

GOP Sen. Tom Cotton of Arkansas weighed in over Twitter Thursday against the House GOP effort, which leaders hope to send to the Senate in time for final passage by early April.

"House health care bill can't pass Senate w/o major changes. To my friends in House: pause, start over. Get it right, don't get it fast," Cotton wrote, contending that Republicans are making the same mistake Democrats did when they passed the Affordable Care Act in the first place by moving forward with little time for review and without official cost estimates from the Congressional Budget Office.

The American Medical Association, the American Hospital Association and AARP, the nation's largest advocacy group for older people, were arrayed against the measure. Seven years ago their backing was instrumental in enacting Obama's health care statute.

A national association of hospitals — major employers in many districts — wrote lawmakers complaining about the bill's cuts in Medicaid and other programs and said more uninsured Americans seem likely to result, adding, "We ask Congress to protect our patients." Groups representing public, children's, Catholic and other hospitals also expressed opposition.